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General NPI Number Information
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NPI Number | 1467860163
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Entity Type | Organization
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Legal Business Name | SOUTH JERSEY PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 07/25/2014
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Last Update Date | 09/08/2014
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Provider Practice Location Address
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Address Line | 1299 ROUTE 38 SUITE 9
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City | HAINESPORT
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State | NJ
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Zip | 08036-2791
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Country | US
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Telephone | 609-845-3585
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Fax |
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Provider Business Mailing Address
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Address Line | 1299 ROUTE 38 SUITE 9
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City | HAINESPORT
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State | NJ
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Zip | 08036-2791
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Country | US
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Telephone | 609-845-3585
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. DANIEL LINICK
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Credential | PT, DPT
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Telephone | 609-845-3585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 40QA1339700
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License Number State | NJ
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